Efficiency and Effectiveness (E)

Empowering countries to get the most impact from their health programs
Increasingly, global attention is focusing on maximizing policy and program synergies between HIV and other health services, especially those related to sexual and reproductive health, maternal and child health, tuberculosis, and malaria. This enhanced program efficiency will continue to challenge country health systems. At the same time, the demand for effectiveness continues to increase while resources are decreasing. Efficiency and effectiveness in national health programming known as E - has never been more important. With years of experience in this area, Futures Group views the E as transformative. It helps countries to: Identify ways to get the greatest impact from money invested; Optimize the quality and quantity of services; and Take control of the critical decisions that affect health services.

Program Areas
population and family planning sexual and reproductive health maternal and child health hiv and aids infectious diseases gender poverty and equity

Futures Group works with partner countries to find solutions that support national health priorities. We help examine the performance of current and planned programs looking at program cost, efficiencies, proven interventions and local context. We strengthen countryled programs by providing tools and information to decisionmakers, creating action plans to achieve desired outcomes, and building local capacity so partners can do this work themselves. With trained staff working with tools that can be updated and adjusted, national health programs can more closely monitor program efficiency and effectiveness. Through the USAID | Health Policy Project, Futures Group established a new E program in Kenya in 2011, and will expand to other African countries in 2012. Futures Group also supported the International AIDS Society in its development of key research areas and partnerships for an Africa-wide consultation on Efficiency and Effectiveness in early 2012.

Technical Services
policy and advocacy research and strategic information ealth markets and private sector h engagement modeling and economic analysis health systems strengthening strategic consulting program management

futures group offerings:

Country E Reviews

Futures Group convenes country leaders across health, finance, economics, statistics, policy, and planning to review a wide range of data and modeling to find savings and efficiencies, as well as identify what programs work best. Supportive Health Policy Through the Health Policy Project, we give a holistic view of health systems, including applying models on what services are needed in the future and what it will cost to scale up those programs.

Tools and Technical Assistance We train in-country teams how to use E tools so the programs become sustainable and the leaders can keep close watch over program performance.

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The E process is designed to give more of a leadership role to the countrys agencies, rather than having it led by outsiders giving technical assistance. That can take a little more time and include more meetings and more people participating, but it really pays off. When countries take charge, it creates that goodwill for programs, and it gives the whole effort a lot of energy, which leads to better outcomes.
Arin Dutta Senior Economist, Futures Group

Approach in Action: Kenya

With uncertain levels of future funding from international donors for its HIV programs, the Kenyan government realized that it had to develop more sustainable funding sources and break the dependence on donors. Through a project funded by USAID, Futures Group works with the National AIDS Control Council and National HIV/AIDS and STD Control Program of Kenya to improve HIV program efficiencies and effectiveness. This work supports a culture of constant improvement through the use of E tools and process. Futures Group helped form a technical working group with representatives from multiple agencies to begin E analyses and assess potential gains across the Kenyan HIV/AIDS response. We conducted more than 20 interviews with key stakeholders, and collected secondary data and financial information to share with the technical working group. Following a pilot E project, the USAID | Health Policy Project will continue to provide technical assistance to the working group through 2012. The goal is to develop an E methodology that helps enhance program results and close the gaps in HIV funding. This approach will be replicated with other health programs.

Photo Credit: Brad Ruggles

My vision is to see all of Africa coming together and looking at the whole issue of effectiveness and efficiency. If we do it right in Kenya, it will change the way we do our programs and make our priorities. We are moving in a direction that will result in more sustainable delivery of services. Regina Ombam Head of Strategy Development Kenyas National AIDS Control Council

The Country Perspective

In 2011, the government of Kenya faced a rise in demand for AIDS and other health services and a significant loss of donor support. Regina Ombam, Head of Strategy Development for the National AIDS Control Council, knew that she needed to prioritize programs and find ways to make the governments money stretch further and somehow deliver more. Ombam turned to Futures Group, asking for analyses on what was most effective and efficient. She wanted historical records as well as models that would help forecast future needs. We started looking at the different programs prevention of HIV infection from mother to child, antiretroviral therapy, and care programs and we looked at how we were running those programs and whether we were getting value for money, she said. What they found was a need for better coordination of HIV/AIDS programs in the country. We realized we had so many players in the HIV field in our country and we really didnt know who was doing what where, she said. We needed to be holding all groups responsible for whatever they were doing. Now, after the first set of analysis, that sought to answer key questions on efficiency, effectiveness, and ownership of our HIV programs, we know now what needs to take first priority, second priority, and third priority, in all areas of the country, she said. Were all about change changing right now in our prioritization of HIV programs. We will make it happen.
Photo Credit: National AIDS Control Council

Futures Group, the global health consulting firm, helps to protect and promote peoples well-being around the world. For 40 years, Futures Group has created lasting solutions to some of the most pressing public health challenges facing nations. For more information, please visit www.futuresgroup.com, www.facebook.com/FuturesGroup, and www.twitter.com/FuturesGroupGbl.